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LOCKING COMPRESSION PLATE, IS IT A PIECE OF THE DEVIL?



Abstract

Locking compression plate is part of a new plate generation requiring an adapted surgical technique and new thinking about commonly used concepts of internal fixation using plates.

They offer a number of advantages in fracture fixation combining angular stability through the use of locking screws with traditional fixation techniques. This makes the implant suitable for poor bone stock and for fractures in metaphyseal areas.

However the system is complex and cases of plate loosening and plate breakage reported by many authors recently, many of these authors believe it is attributed to the choice of inappropriate plate and/or fixation technique rather than to the features of locking compression plate system.

We are reporting 2 cases of plate breakage after using it to fix diaphyseal femoral shaft fractures; in each case we discuss the pitfalls in the fixation method.

The locking plate manual did not highlight the important pitfalls, which was published later on in the literature as guidelines for their clinical application. Careful and detailed attention to the biomechanical principles of locking compression is crucial to the success of implant in fixing fractures in diaphyseal areas.

The abstracts were prepared by Editorial Secretary Jean-Claude Theis. Correspondence should be addressed to NZOA at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.